River Blindness (onchoceriasis)

River blindness or onchoceriasis is a disease caused by parasitic worms present in black flies that reside in rivers with fast flowing waters. This disease is most common and is originally discovered in Africa where the black flies dwell in great numbers by the riverbanks. The parasite responsible for river blindness is Onchocerca volvulus, which is where the medical term for the illness, onchoceriasis, originated.

Though the disease is not fatal, it could however cause some deformities and blindness over the years. When the black flies lay the parasitic worms onto the skin, these parasites would delve deeper into the nodules of the skin where they will make their home in for as long as 15 years. And as the years progress, these worms would breed more parasites that could attack the person’s skin tissues, muscles and the eyes. And over time, the person would feel the different signs and symptoms of river blindness, and if the disease is not addressed right away, it could lead to the loss of eyesight.

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What are the Symptoms of River Blindness?

The early detection of an illness is ideal or preferred so that the treatment plan could be laid out or a quick and effective resolution of the disease. However, in the case of river blindness, early detection is almost impossible as the symptoms would usually reveal themselves only after 4 to 15 months of the infection of the parasites. Below are the symptoms of onchoceriasis:

  • Formation of nodules on either the lower part (below the waist) or the upper part of the body (mostly on the head). These nodules are formed due to the growing or breeding parasites underneath the skin.
  • Development of lesions and rashes that could cause severe itchiness. Swelling could also occur in some cases which would cause a hot and painful feeling to the skin. The itching could also be inconsistent, that is, it wouldn’t itch at times but would suddenly shoot up to an intense itchy feeling.
  • Swelling of the lymph nodes is also a common symptom because these are the sites where the parasites usually breed and multiply.
  • In worse cases, some would experience elephantiasis of the groins or the genitals. Elephantiasis is the enlargement or swelling of the body part which the parasites have invaded.
  • Weakness of the body is also a symptom. As the parasites multiply, they begin to attack the body’s muscles and tissues which would result to muscle weakness and fatigue.
  • The appearance of the skin would greatly change as it would become wrinkled and the color altered due to depigmentation.
  • The microfliariae (the offspring of the adult parasites) would attack the tissues of the eyes, thus, eventually causing blindness. The early symptoms of total blindness would include red and itchy eyes as well as photophobia or high sensitivity to light.

How is River Blindness Diagnosed?

In order to confirm the disease, the doctor would run these different tests:

  • Physical examination – The doctor would assess the presence of swelling lymph nodes through palpitation. He or she would also check for rashes and any discoloration of the skin.
  • Laboratory tests – These include skin snip examination where the doctor would take a sample of the affected skin and would culture this to detect the presence of the O. volvulus parasite. Another famous lab test for river blindness is the use of ELISA or enzyme linked immunosorbent assay. A sample of the patient’s blood will be collected and ELISA could help detect the presence of the parasite that caused the illness.

River blindness treatment

River blindness still has no perfect cure yet. Some drugs can kill the parasites but could not reverse some of the illness’ symptoms such as elephantiasis. Blindness, on the other hand, can be prevented by controlling the multiplication of the parasites with the use of medicines.

The most popular medicine and the drug of choice for the treatment of this condition is Ivermectin. This drug would help kill the parasites present in the body. However, Ivermectin needs to be administered in repeated doses for three to twelve months, depending on the severity of the case. For worse cases, higher doses and more frequent administration should be done as recommended by the physician. Topical corticosteroids could also be prescribed by the doctor to control the itching of some developing rashes on the skin.

River blindness can be prevented. If you live in a humid place alongside a strong flowing river, a repellant with DEET or diethyltouamide would help protect your skin from the attack of black flies that could possibly be residing near your area. And if you go outdoors, wear something that would protect your skin, such as long-sleeved clothing, head nets and the like.

However, if you suspect any of the symptoms of river blindness, it is best to see the doctor right away in order to prevent the condition from getting worse.

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